Americans Get More Mammograms, Colonoscopies, etc. than Europeans
We don’t get a little bit more. We get a whole lot more. But first things first.
If you are like me you probably have noticed a claim being repeated over and over again, like a steady drumbeat: that Americans spend more, but get less care. The latest, from the Commonwealth Fund (CWF), is published in Health Affairs. According to the journal’s press release:
American doctors are significantly behind many of their counterparts elsewhere in providing access to high-quality care and use of health information technology.
According to CWF, U.S. physicians are worse than those other developed countries at providing after-hours care — leaving no choice but the emergency room. Far more than in other countries, U.S. patients have difficulty paying for medications and care and U.S. doctors are more likely to be hampered by insurance coverage restrictions.
“Our weak primary care system puts patients at risk and results in poor health outcomes and higher costs,” CWF president Karen Davis told Reuters. Other countries have solved problems the United States is still struggling to conquer, she said. “U.S. primary care lags behind care in other countries on key measures,” said a Health Affairs press announcement.
All this had me in a real funk until I discovered through my own prying — and without the aid of any press release — an article in THE VERY SAME JOURNAL that reported on the care actual patients actually receive. You can’t imagine how surprised I was.
As the graphic below shows:
- Among women age 50 to 54, Europeans get only 88% as many Pap smear tests and only 60% as many mammograms as Americans do, on a per capita basis.
- In the same age bracket, Europeans get only two-thirds as many prostate cancer tests and less than half as many colonoscopies.
- As patients age, the difference in cancer screening rates between the U.S. and Europe becomes even more pronounced.
- At age 75 and above, European women get little more than half as many Pap smears and about one-fifth as many mammograms.
- Also at age 75 and above, Europeans get a bit more than half as many PSA tests and about one-third the number of colonoscopies that Americans receive.
This is consistent with other information loyal readers can find at this blog. We previously reported that America has the highest cancer survival rates in the world. And compared to Canada, Americans get significantly more preventive care. In fact, even uninsured Americans get as much or more preventive care than Canadians do.
The CWF study is only the latest in a series of publications whose whole sole purpose seems to be to bash U.S. health care vis-à-vis the systems of other countries. The journals are so obliging that we found it necessary to self-publish our own review of the literature — which readers, I believe, will find refreshingly objective.
The obvious questions are:
- How could the Commonwealth Fund have overlooked such telling results?
- Why did the Health Affairs press office find that a study of process is more newsworthy than a study of differences in actual care?
- Why is Health Affairs making the full article about process available to the general public, but keeping the findings about actual care gated?
- Why do health reporters allow press releases to distract them from genuine newsworthy findings?
Readers are welcome to supply answers in the comments section. (Try to be polite.)
Very interesting. Thanks for this post.
The answer to your questions, John, is that Health Affairs and the Commonwealth Fund are taking sides in the health reform debate. Didn’t you say the other day that truth is the first casualty in such debtes?
I know your questions are rhetorical.Surely you aren’t suggesting that Karen Davis (and Steffi Woolhandler et al)has an agenda she is pushing?
I knew CWF has a agenda. I’m surprised that Health Affairs seems to share that agenda.
You should not have been surprised. June O’Neill had a major paper a couple of years ago showing that Americans have better care than Canadians, in terms of routine screenings and cancer survival rates. Did you see my article last week in Forbes.com? It’s about cancer survival rates in Europe vs America. I attack Senator Franken, who asserts the opposite. Here is the link: http://www.forbes.com/2009/11/04/cancer-survival-health-care-reform-opinions-contributors-diana-furchtgott-roth.html
Maybe the Health Affairs editors live in states with such over regulated health care systems that they have no idea that in other states people have an array of choices for after hours care from groups that specialize in it?
Where I am there are after hours pediatric practices to go along with clinics and the usual urgent care set-ups. ERs are far from the only choice. Maybe Health Affairs needs to get out more.
Well done, John.
Thanks, Linda. It’s unbelievable how these people think. Or don’t think.
Why is this surprising. Look at the funding source for CWF. Inmy book I documented the comparison and results of care in America which is superior. If you want facts go to http://www.robertblades.com
From an academic standpoint, it is an interesting demonstration of how much power the top journals have to shape press coverage of health policy and medicine. But, as one of the authors of the study on screening rates, it was somewhat disappointing to see the imbalance in attention. Keep up the good work.
Very interesting Health Alert.
I have one question to ask our current administrations in regards to health care. It requires a yes or no answer, no additional rhetoric or explanation.
Will all government employees, including the employees of the executive branch of our government, and their families fall under the same guidelines and requirements as the rest of Americans?
Or will they be exempt?
The cancer-screening data support what America’s seniors know: Their ability to get adequate care via Medicare depends on a thriving private market for non-seniors to support it – both through financing the “hidden tax” or cost shift from government payers to private payers, and as a method of keeping expectations for care high.
The Commonwealth Fund survey of primary-care doctors does not take into account that U.S. primary-care doctors take care of a lot of patients who are dependent on Medicare or Medicaid, and they are likely to be sicker than the privately insured.
Also, Exhibit 6 reports U.S docs have better than average hassle with regulatory compliance.
All in all, the survey doesn’t really indicate a course of action.
It is no secret to those who bother to read the actual studies of these medical journals and “think tanks” that they play loose and fast with the facts in their attempt to sway public debate. The whole foundation of healthcare research has been contaminated with those appointed and marinating within the same academic environment that is increasingly undergirded by Marxist/statist intelligentsia seeking to indoctrinate our college youth–especially within our largest, most prominent institutions. The problem is this foundation has been allowed to simmer for decades beneath the radar without confrontation such that a compost of statist intellectual thought has its tenacles wrapped around our government and we are reaping the results within the current healthcare debate.
Don’t hold back, hoads. Tell us what you really think.
I think this makes Health Affairs look really bad. What are they saying in their own defense?
Never before has the American people needed to take charge and speak up to advocate for themselves and others. Get everything medically related checked out now because there will soon be a day when YOU will be told whether or not you actually are “in need” of health care. What I want to know is, is Nancy Pelosi or any other politician going to have the same kind of socialized healthcare that they are trying to ram down the throat of the American people? How committed are they to “NEW HEALTHCARE REFORM?”
Well OF COURSE we Americans get more tests than Europeans. That’s their whole argument. . .that our extra tests are unnecessary!
You only need to look at the current H1N1 vaccine shortage to see what Obama Care will do for the country. In 1993, the Clinton Administration created the Vaccines for Children (VFC) program. Then as now, the President implied that profiteering providers made health care too expensive. According to President Clinton, vaccine manufacturers were “pursuing profits at the expense of our children.
In 2003, the Institute of Medicine reported that the number of vaccine producers licensed for the U.S. market had fallen from 26 in 1967 to 4 in 2002. Factors cited for the decline included more stringent regulation, concerns about tort liability, and “poor returns on investment” that were, informed observers contend, a result of regulatory recklessness and the misuse of the VCP pricing power.
This what we will have with Obama Care!
Americans get more tests because it has a for-profit healthcare system!! Odd isn’t it that Canadians are overall healthier, have lower infant mortalities rates and a longer life span than Americans. More testing doesn’t mean better healtcare. Sorry to burst your anti health care reform bubble.